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NT-proBNP, fluid volume overload and dialysis modality are independent predictors of mortality in ESRD patients.
Nephrol Dial Transplant. 2010 Feb; 25(2):551-7.ND

Abstract

BACKGROUND

N-terminal fragment of B-type natriuretic peptide (NT-proBNP) is a marker of both fluid volume overload and myocardial damage, and it has been useful as a predictor of mortality in patients with end-stage renal disease (ESRD). It has been suggested that continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and haemodialysis (HD) may have different effects on fluid volume and blood pressure control; however, whether the independent predictive value of NT-proBNP for mortality is preserved when analysed in conjunction with fluid overload and dialysis modality is not clear.

METHODS

A prospective multicentre cohort of 753 prevalent adult patients on CAPD, APD and HD was followed up for 16 months. Plasmatic levels of NT-proBNP, extracellular fluid volume/total body water ratio (ECFv/TBW) and traditional clinical and biochemical markers for cardiovascular damage risk were measured, and their role as predictors of all-cause and cardiovascular mortality was analysed.

RESULTS

NT-proBNP level, ECFv/TBW and other cardiovascular damage risk factors were not evenly distributed among the different dialysis modalities. NT-proBNP levels and ECFv/TBW were correlated with several inflammation, malnutrition and myocardial damage markers. Multivariate analysis showed that NT-proBNP levels and ECFv/TBW were predictors of both all-cause and cardiovascular mortality, independently of dialysis modality and the presence of other known clinical and biochemical risk factors.

CONCLUSIONS

NT-proBNP is a reliable predictor of death risk independently of the effect of dialysis modality on fluid volume control, and the presence of other clinical and biochemical markers recognized as risk factors for all-cause and cardiovascular mortality. NT-pro-BNP is a good predictor of mortality independently of fluid volume overload and dialysis modality.

Authors+Show Affiliations

Unidad de Investigación Médica en Enfermedades Nefrológicas, Hospital de Especialidades, CMN Siglo XXI, Mexico City. jpaniaguas@cis.gob.mxNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19679559

Citation

Paniagua, Ramón, et al. "NT-proBNP, Fluid Volume Overload and Dialysis Modality Are Independent Predictors of Mortality in ESRD Patients." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 25, no. 2, 2010, pp. 551-7.
Paniagua R, Ventura MD, Avila-Díaz M, et al. NT-proBNP, fluid volume overload and dialysis modality are independent predictors of mortality in ESRD patients. Nephrol Dial Transplant. 2010;25(2):551-7.
Paniagua, R., Ventura, M. D., Avila-Díaz, M., Hinojosa-Heredia, H., Méndez-Durán, A., Cueto-Manzano, A., Cisneros, A., Ramos, A., Madonia-Juseino, C., Belio-Caro, F., García-Contreras, F., Trinidad-Ramos, P., Vázquez, R., Ilabaca, B., Alcántara, G., & Amato, D. (2010). NT-proBNP, fluid volume overload and dialysis modality are independent predictors of mortality in ESRD patients. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 25(2), 551-7. https://doi.org/10.1093/ndt/gfp395
Paniagua R, et al. NT-proBNP, Fluid Volume Overload and Dialysis Modality Are Independent Predictors of Mortality in ESRD Patients. Nephrol Dial Transplant. 2010;25(2):551-7. PubMed PMID: 19679559.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - NT-proBNP, fluid volume overload and dialysis modality are independent predictors of mortality in ESRD patients. AU - Paniagua,Ramón, AU - Ventura,María-de-Jesús, AU - Avila-Díaz,Marcela, AU - Hinojosa-Heredia,Héctor, AU - Méndez-Durán,Antonio, AU - Cueto-Manzano,Alfonso, AU - Cisneros,Alejandra, AU - Ramos,Alfonso, AU - Madonia-Juseino,Clara, AU - Belio-Caro,Francisco, AU - García-Contreras,Fernando, AU - Trinidad-Ramos,Pedro, AU - Vázquez,Rosario, AU - Ilabaca,Begoña, AU - Alcántara,Guadalupe, AU - Amato,Dante, Y1 - 2009/08/12/ PY - 2009/8/15/entrez PY - 2009/8/15/pubmed PY - 2010/5/21/medline SP - 551 EP - 7 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 25 IS - 2 N2 - BACKGROUND: N-terminal fragment of B-type natriuretic peptide (NT-proBNP) is a marker of both fluid volume overload and myocardial damage, and it has been useful as a predictor of mortality in patients with end-stage renal disease (ESRD). It has been suggested that continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and haemodialysis (HD) may have different effects on fluid volume and blood pressure control; however, whether the independent predictive value of NT-proBNP for mortality is preserved when analysed in conjunction with fluid overload and dialysis modality is not clear. METHODS: A prospective multicentre cohort of 753 prevalent adult patients on CAPD, APD and HD was followed up for 16 months. Plasmatic levels of NT-proBNP, extracellular fluid volume/total body water ratio (ECFv/TBW) and traditional clinical and biochemical markers for cardiovascular damage risk were measured, and their role as predictors of all-cause and cardiovascular mortality was analysed. RESULTS: NT-proBNP level, ECFv/TBW and other cardiovascular damage risk factors were not evenly distributed among the different dialysis modalities. NT-proBNP levels and ECFv/TBW were correlated with several inflammation, malnutrition and myocardial damage markers. Multivariate analysis showed that NT-proBNP levels and ECFv/TBW were predictors of both all-cause and cardiovascular mortality, independently of dialysis modality and the presence of other known clinical and biochemical risk factors. CONCLUSIONS: NT-proBNP is a reliable predictor of death risk independently of the effect of dialysis modality on fluid volume control, and the presence of other clinical and biochemical markers recognized as risk factors for all-cause and cardiovascular mortality. NT-pro-BNP is a good predictor of mortality independently of fluid volume overload and dialysis modality. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/19679559/NT_proBNP_fluid_volume_overload_and_dialysis_modality_are_independent_predictors_of_mortality_in_ESRD_patients_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfp395 DB - PRIME DP - Unbound Medicine ER -